The effectiveness of manual therapy, rehabilitation and physical activity in the treatment and management of patients with haemophilia: A narrative review.
Item
- Title
- The effectiveness of manual therapy, rehabilitation and physical activity in the treatment and management of patients with haemophilia: A narrative review.
- Title
- The effectiveness of manual therapy, rehabilitation and physical activity in the treatment and management of patients with haemophilia: A narrative review.
- Author(s)
- Strong Anna
- Abstract
- Background: Bleeding into joints (haemarthrosis) and muscle are common manifestations of haemophilia and lead to musculoskeletal dysfunction. Management of these manifestations by physical therapists include manual therapy, rehabilitation exercises and guidance regarding safe physical activity participation. Objective: To appraise recent evidence regarding manual therapy, rehabilitation and physical activities in the treatment and management of haemophilic patients. Methods: Systematic literature searches of several databases and specialist medical journals. Guidelines for systematic review were modified for use with narrative review. Validated appraisal tools were used to evaluate eligible papers. Results: Intense physical activity does not increase frequency of bleeding and may protect against reduced bone mineral density, providing clotting factor levels are maintained. Rehabilitation programmes improve muscle strength and proprioception. Manual therapy research is limited, but no adverse events are reported. Conclusion: The risk of bleeding related to physical activity is inconclusive. Severity and frequency of bleeding related to specific activities needs further research. Vigorous physical activity may protect against low bone mineral density, but larger studies are needed. Future challenges for haemophilia management will be to balance risks of weight-bearing activities to cause bleeding and disability, against benefits to bone mineral density. Studies that isolate rehabilitation techniques will help determine those that are most beneficial. More robust evidence about the effects of manual therapies is required before clear conclusions are drawn.
- Abstract
- Background: Bleeding into joints (haemarthrosis) and muscle are common manifestations of haemophilia and lead to musculoskeletal dysfunction. Management of these manifestations by physical therapists include manual therapy, rehabilitation exercises and guidance regarding safe physical activity participation. Objective: To appraise recent evidence regarding manual therapy, rehabilitation and physical activities in the treatment and management of haemophilic patients. Methods: Systematic literature searches of several databases and specialist medical journals. Guidelines for systematic review were modified for use with narrative review. Validated appraisal tools were used to evaluate eligible papers. Results: Intense physical activity does not increase frequency of bleeding and may protect against reduced bone mineral density, providing clotting factor levels are maintained. Rehabilitation programmes improve muscle strength and proprioception. Manual therapy research is limited, but no adverse events are reported. Conclusion: The risk of bleeding related to physical activity is inconclusive. Severity and frequency of bleeding related to specific activities needs further research. Vigorous physical activity may protect against low bone mineral density, but larger studies are needed. Future challenges for haemophilia management will be to balance risks of weight-bearing activities to cause bleeding and disability, against benefits to bone mineral density. Studies that isolate rehabilitation techniques will help determine those that are most beneficial. More robust evidence about the effects of manual therapies is required before clear conclusions are drawn.
- presented at
- British School of Osteopathy
- Date Accepted
- 2011
- Date Submitted
- 3.2.2012 00:00:00
- Type
- osteo_thesis
- Language
- English
- Pub-Identifier
- 15107
- Inst-Identifier
- 780
- Keywords
- Haemophilia, osteopathy, physical therapy, exercise
- Recommended
- 0
- Item sets
- Thesis
Strong Anna, “The effectiveness of manual therapy, rehabilitation and physical activity in the treatment and management of patients with haemophilia: A narrative review.”, Osteopathic Research Web, accessed May 2, 2025, https://www.osteopathic-research.com/s/orw/item/1733